- Sedgwick (Orlando, FL)
- …naturally empathic and solution-focused. **ESSENTIAL RESPONSIBLITIES MAY INCLUDE** + Makes claim determinations to approve non-complex disability claims or makes ... your 2+ years' experience in a office setting or medical experience and grow with us! + A stable...professional needs. **PRIMARY PURPOSE OF THE ROLE:** To process claims and determine benefits due pursuant to a disability… more
- City of Coral Gables, FL (Coral Gables, FL)
- …statutory time frames. Act as primary liaison among injured employees, managers, medical providers, and insurance representatives. Monitor claim status, reserve ... and supports overall risk-management activities. The role manages workers' compensation claims from first report through closure, partners with internal stakeholders… more
- AdventHealth (Maitland, FL)
- …and Medical appeals, refunds, reinstatements and rejections of insurance claims with the oversight of the Supervisor and/or Manager Qualifications **EDUCATION ... information for accurate billing. Processes daily error logs, stalled reports, aging claims , and any ah-hoc reports. Addresses claim issues from insurance… more
- Elevance Health (Tampa, FL)
- …coding or quality assurance environment preferred. + Broad knowledge of medical claims billing/payment systems provider billing guidelines, payer reimbursement ... -expense spending. The **DRG CODING AUDITOR** is responsible for auditing inpatient medical records and generating high quality recoverable claims for the… more
- Akumin (Tampa, FL)
- **The Medical Biller** is responsible for submitting medical claims to government and private payers. Ensures that service date, CPT code, necessary ... normal workflow. **Specific duties include, but are not limited to:** + Submits medical claims to payers via electronic data interchange (EDI,) paper claims … more
- UNUM (Tallahassee, FL)
- …Physical Medicine and Rehabilitation. This position is responsible for providing expert medical analysis of claims files (or underwriting applications) across ... and efficient medical consultative services to the Benefits Center. The Medical Consultant adheres to current regulatory, claim process, and internal… more
- CVS Health (Tallahassee, FL)
- …credentialing/re-credentialing and contracting questions and issues. + Assist in compiling claim data for audits. Determines medical necessity, applicable ... services for high volume inbound provider calls for the Claims Inquiry/ Claims Research Medicaid team. Extensive ...rights and responsibilities in accordance with contract. + Process claim referrals, new claim handoffs, nurse reviews,… more
- BrightStar Care (Naples, FL)
- …a database using this set medical protocol to produce a statement or claim . * Investigate rejected claims , verify this information with the health provider, ... years . We are looking for the an experienced medical Billing and Payroll Specialist . Responsibilities include weekly...payroll.. Managing Authorizations , appeals and re- submission of claims . Posting cash etc. Must be detail oriented… more
- Sedgwick (Tampa, FL)
- …General Adjuster - Southeast Region **PRIMARY PURPOSE** **:** To handle losses or claims regionally unassisted up to $10M, including having the ability to address ... and non-complex National Accounts. **ESSENTIAL FUNCTIONS and RESPONSIBILITIES** + Examines claim forms and other records to determine insurance coverage. +… more
- The Hartford (Lake Mary, FL)
- …focused initial and ongoing Long Term Disability benefit determinations using vocational, medical , and financial claim management. The Senior Ability Analyst ... after an unexpected event or illness happens while following corporate claim standards, policies, and procedures, and statutory, regulatory and ethics requirements.… more